Scholarship Appeals Application

Say Yes Guilford understands that sometimes students experience extenuating circumstances that may have an impact on their education. Please complete this form in its entirety. Once a decision has been made about your appeal, Say Yes Guilford will contact you with the outcome.

Continuous Enrollment

If you do not meet the continuous enrollment requirements due to one of the reasons listed below and wish to request special consideration please provide the information below.

Which of the following is causing your ineligibility?
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Documentation will be required on next page

Please explain why you do not meet the Say Yes eligibility requirements and describe your extenuating circumstances in detail:
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Income

If you do not meet the family income requirements due to one of the reasons listed below and wish to request special consideration please provide the information below. We encourage you to touch base with your institution to discuss changes in income as well.

Which income bracket do you fall into based on 2015's Adjusted Gross Income?
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Documentation will be required on next page

Which of the following is an accurate representation of your current income?
*

Documentation will be required on next page

Which of the following is causing your ineligibility?
*

Please explain why you do not meet the Say Yes eligibility requirements and describe your extenuating circumstances in detail:
*

Credits/GPA

If you do not meet the requirements due to one of the reasons listed below and wish to request special consideration please provide the information below.

Which of the following is causing your ineligibility?
*

Documentation will be required on next page

Please explain why you do not meet the Say Yes eligibility requirements and describe your extenuating circumstances in detail:
*

Medical Circumstance

Please explain and describe the medical circumstance relating to the reason why you do not meet the Say Yes eligibility requirements in as much detail as possible.
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Other

Please explain why you do not meet the Say Yes eligibility requirements and describe your extenuating circumstances in detail:
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SUGGESTED DOCUMENTATION

Appeals submitted for review must include all necessary documentation. Suggested documentation may include, but are not limited to the following based on the appeal type:

File 1

File 2

File 3

File 4

File 5

CHECKBOX SIGNATURE
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I understand that checking this box constitutes a legal signature confirming that I understand that the information I submit with my request will be shared with a committee in order for a decision to be rendered on my behalf and that the information provided above is accurate. I understand that by submitting falsified or fraudulent information that I will lose all scholarship eligibility.